Tuesday, December 25, 2007

A true Southerner once told me you can say anything about someone as long as you end the rant with "bless their hearts..."

So here it goes. I apologize now for my complaining and rambling.

I am seriously losing my patience and compassion. People are often demanding, difficult, and neurotic. What honestly makes people think they are the center of the universe and that the need to rearrange their bedside table is so much more important than excruciating pain, delirium, death, etc....? Do people honestly think they have rented my personal attention out by the hour? Maybe I should educate them about our premium suite unit where they can pay $500 extra dollars a night to have personal nursing attention and a private chef? Do they think that I have nothing better to do than find Wheel of Fortune on the tv for them...for the third time in an hour? That I have unlimited narcotics in my back pocket? That I run Mayo Clinic and can change the system that serves over 100,000 patients a year in 20 minutes just for them? That I can devise a shorter route to get to x-ray across one of the biggest hospitals in the States because they don't feel like taking a ride for 10 minutes?

Hospital nursing makes me want to drink much more than the single bottle of delicious Merlot my roommate gave me for Christmas. I yelled at a dying man today. I don't really feel bad about it because he yelled at me in confusion and restlessness for 12 hours. He had a reason to yell, because he's fatally bleeding out through his scrotum. (Yes, wince greatly, guys). But I had had enough of the yelling and all my other patients and the non-nursing staff freaking out because they could hear him screaming.

I flat-out laughed at another man to his face today. He had big-time pain too, from multiple weeping sores in his tree trunk sized legs. One leg was bleeding all over the place, open without a dressing to catch the myriad of nasty bugs that can be found on almost every surface in a hospital. So I attempted to dress it, like a good nurse should. He yelled. He cursed. He told me to leave him alone. That he couldn't believe that in the best hospital in the world (that is debatable) with the best nurses in the world (probably untrue) that he couldn't believe we would do such a thing.

I laughed in his face. And kept dressing his gross wounds while he belittled every aspect of my professional practice. He called me his angel later in between breaths of yelling at his doctor because I brought the almighty pain meds. Oh, how the tides turn...

I got a new admission in the middle of morning craziness. I put him in his room and didn't talk to him for 4 hours. I just looked in on him as I walked past the door. I made the judgment that he was ok and could wait until I got everything else settled. I talked to him for 15 minutes to get the necessary paperwork done, and barely saw him the rest of the day. Screaming dying guy, cussing leg wound guy, along with teary diarrheal grandma were enough to fill the rest of my day.

Not one of my patients could walk by themselves. Only one could actually turn himself over. All but one is diabetic, which means frequent blood sugar checks and subsequent insulin shots. 3 had multiple IV meds. Dying guys gets pain and anxieymeds every hour (yet still screams). 2 had diarrhea (remember, they can't walk...) One can't pee at all. One pees constantly. 2 are bleeding. 2 were crying. One guy is detoxing from alcohol and pot.

Oh, and it's Christmas, so every family member from here to California is calling and wanting to talk to their loved one. The phone is right beside them, but, alas, they can't turn over to pick it up. So who gets paged to talk to their family on the phone, go down the hall to look up the room phone number, come back to the original phone, transfer the call in the room, then run down the hallway to go pick it up? That would be me. And me again. And again.

Did I mention that all the other patients on the unit are just as intense and 50% of our staff for the day were not our regular nurses (i.e. they don't know where anything is, how our systems work, that we are a pilot unit for a whole new computer system...)? I felt worse for them than I did my own situation. So to keep those nurses from crying, I tried to do what I could for them. And it seems respiratory therapy, physical therapy, occupational therapy, lab techs, iv techs, and catheter techs all had a magnetic attraction to me with random questions as if I held the magical answer concerning every problem for every patient down the whole 36 bed hall. Chaos.

So we have this classification system that determines our nursing/patient ration that we fill out several times a day. 1-6, with 6 as the most intense care you can get. A 5 usually earns you a nurse to yourself. Today my patients classified as two 5s and two 3s. And it was just me.

Even the medical staff recognized what a ridiculous day it was. I had one resident seek me out to give me a high five for the way I handled crisis #23 of the day and a consultant praise me in front of his whole team for my suggestions concerning meds and a feasible plan for leg wound guy. Two families thanked me for my care, one calling me the best damn nurse they'd had in all their husband's hospitalizations.